1993, 04-02 Permit App: 93002117 Mechanical Fixtures. JOB STREET ADDRESS:
CITY/STATE/ZIP
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Information Voldustmbet
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MAILING ADD
PHONE NUMBER:
(Street)
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(City/Stats) (Zip)
CONTRACTOR: Q A��ae N s G - M �+-� LICENSE NUMBER: g 0,44 -Tp t4_ ► to S Z....
PHONE NUMBER: qzt . Se o c1
MAILING ADDRESS: GC t\ E t.L i F t .4"3 . �+t-....... tw�wc. i � c4 2.0
(Street) (Ci y/State) (Zip)
11111.11.11111111111011.1.111111.1.111111
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
=AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
AIR CONDITIONER 0-3 TONS
AIR CONDITIONER 3-15 TONS _
AIR CONDITIONER 15-30 TONS _
AIR CONDITIONER 30-50 TONS _
AIR CONDITIONER +50 TONS
FANS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' P'I'N. OF HOOD1
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTO _
UNLISTED GAS APPLIANCE >400,000 BTU _
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
NOTE: ;,eta $35.410
SIGNATOR.
SUBTOTAL
x$10.00
25.00
10.00
12.00
15.00
4.00
1.00
12.00
20.00
25.00
35.00
60.00
12.00
20.00
25.00
35.04
60.00
10.00
10.00
50.00
10.00
x 10.00
x 10.00
x 10.00
x 10.00
x 50.00
x100.00
x 50.00
x100.00
x 12.00
x 15.00
Mit
Mt
PLS: PROCESSING FEE
/C). OO
o? . 00
4/.00
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
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